The objective of the continuation study is to understand the long- term effects of pursing intervention on the development of attachment between an infant and his/her mother. Specifically, the study, at eighteen months of the infant's life, aims to: 1) assess the long-term effect of mediated instruction designed to increase the mother's sensitivity to the capacity of her infant for interaction on the development of mother-infant attachment; 2) determine the most appropriate time to offer mediated instruction; 3) further document the family, maternal and infant characteristics that influence the development of mother-infant attachment; and 4) conduct the study in a sample of multiethnic and varied socioeconomic backgrounds. The administration of a battery of instruments and procedures at eighteen months post-partum will extend the observation of 260 mothers and their infants enrolled in an originally four-group longitudinal experimental study (Groups A, B, C, D). The treatment of mediated instruction was applied to Group A during the ninth month of pregnancy, to Group B during the hospitalization following delivery, to Group C at two months post-partum, and to Group D, the original control group, at four months post-partum after all data was collected. A fifth group, Group E, will be recruited from the same population to serve as an additional control group in the continuation study. Group E mothers will not have seen the mediated instruction nor will have been exposed to the effects of participation in a longitudinal study. The observation at eighteen months includes measures of mother-infant attachment, infant temperament, social support, family functioning, infant development, and demographic variables. Descriptive, correlational, and multivariate analyses will determine if there is long-term effect of mediated instruction on the development of mother-infant attachment and if the effect is significant beyond that accounted for by maternal, infant, and family variables. The knowledge obtained from this study will be useful in identifying cost-effective nursing interventions that are successful in influencing the development of mother-infant attachment. Such interventions could enhance the quality of health care offered to mothers and infants for the purpose of promoting parenting behaviors. Furthermore, interventions which demonstrate a positive influence on the mother-infant attachment have the potential for preventing failure to thrive in the infant, child abuse, and neglect.